Association of Obesity With Survival Outcomes in Patients With Cancer
| Autor: | Antonio Bossi, Fausto Petrelli, Gianluca Tomasello, Antonio Ghidini, Alessandro Iaculli, Valentina Rampulla, Alessio Cortellini, Alberto Zaniboni, Lorenzo Dottorini, Massimiliano Salati, Mary Cabiddu, Antonio Varricchio, Sandro Barni, Olga Nigro, Michele Ghidini, Alice Indini |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry Incidence Research Nutrition Obesity and Exercise Hazard ratio Cancer General Medicine Global Health Lower risk medicine.disease Obesity Survival Rate Online Only Neoplasms Meta-analysis Internal medicine Epidemiology medicine Humans business Lung cancer Body mass index Original Investigation |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | Key Points Question Is obesity associated with better prognosis in patients with cancer? Findings This meta-analysis of 203 studies with more than 6.3 million participants found that obesity was associated with increased overall and cancer-specific mortality, especially among patients with breast, colon, and uterine cancer. In contrast, patients with obesity and renal cell carcinoma, lung cancer, or melanoma had better survival than patients without obesity. Meaning These findings suggest that survival outcomes are poor among patients with obesity and cancer, except in lung cancer and melanoma. This systematic review and meta-analysis assesses the association between obesity and survival outcomes following a diagnosis of cancer. Importance Obesity, defined as a body mass index (BMI) greater than 30, is associated with a significant increase in the risk of many cancers and in overall mortality. However, various studies have suggested that patients with cancer and no obesity (ie, BMI 20-25) have worse outcomes than patients with obesity. Objective To assess the association between obesity and outcomes after a diagnosis of cancer. Data Sources PubMed, the Cochrane Library, and EMBASE were searched from inception to January 2020. Study Selection Studies reporting prognosis of patients with obesity using standard BMI categories and cancer were included. Studies that used nonstandard BMI categories, that were limited to children, or that were limited to patients with hematological malignant neoplasms were excluded. Screening was performed independently by multiple reviewers. Among 1892 retrieved studies, 203 (17%) met inclusion criteria for initial evaluation. Data Extraction and Synthesis The Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were reporting guideline was followed. Data were extracted by multiple independent reviewers. Risk of death, cancer-specific mortality, and recurrence were pooled to provide an adjusted hazard ratio (HR) with a 95% CI . A random-effects model was used for the retrospective nature of studies. Main Outcomes and Measures The primary outcome of the study was overall survival (OS) in patients with cancer, with and without obesity. Secondary end points were cancer-specific survival (CSS) and progression-free survival (PFS) or disease-free survival (DFS). The risk of events was reported as HRs with 95% CIs, with an HR greater than 1 associated with a worse outcome among patients with obesity vs those without. Results A total of 203 studies with 6 320 365 participants evaluated the association of OS, CSS, and/or PFS or DFS with obesity in patients with cancer. Overall, obesity was associated with a reduced OS (HR, 1.14; 95% CI, 1.09-1.19; P |
| Databáze: | OpenAIRE |
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